Fractures of the Wrist by Mr G J Packer, Orthopaedic Surgeon in Essex, UK.

New Treatments for Fractures of the Wrist

At Southend Hospital we have been using bioabsorbable plates (figures six and seven) over the last seven years. These plates offer the advantages of metal plates in that they are strong enough to fix the fracture well enough to allow immediate mobilization but unlike metal plates they are broken down by the body after about three months and so will help to avoid the problems with the tendons which occur with metal plates. These plates are combined with bone substitutes. We have now published the results of our use of bioabsorbable plates in a peer-reviewed Journal, the Journal of Hand Surgery, and we have also published other papers which demonstrate the technique in terms of the approach to the wrist which we use.

Over the last four or five years it has become more popular to approach the wrist from the volar surface, that is the palmar surface of the wrist.  The advantage of this approach is that it avoids some of the problems associated with having a plate on the back of the wrist.  Since these angularly stable plates have been available, this approach from the palmar side of the wrist has become much more popular.  Whilst this method offers advantages in terms of the fact that there is less chance of tendons being irritated due to the fact the plate is applied to the volar side of the wrist, that is the palmar side where there are far fewer tendons, because the screws which are used have to come through to the dorsal or top side of the wrist there is still the potential for irritation of tendons.  For patients where there is involvement of the joint surfaces it is sometimes difficult to see and reduce (that is put back into place) the joint surfaces from the volar side which limits the use of this approach.

There are now also special plates which can be applied to the specific parts of the wrist which are broken, what is called a column approach.  This means that smaller plates may be applied to specific fragments within the wrist and these can be very useful for particular fracture patterns.

Click here for Patient Information

Return to top of page


This page was last updated on 03/Oct/2007